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Health and Human Services Interim Committee

MINUTES OF THE

HEALTH AND HUMAN SERVICES INTERIM COMMITTEE

July 16, 1997 - 9:00 a.m. -- Room 405 State Capitol



Members Present:    
    Sen. Nathan C. Tanner, Senate Chair
    Rep. Nora B. Stephens, House Chair
    Sen. Robert F. Montgomery
    Sen. Millie M. Peterson
    Rep. Loretta Baca
    Rep. Mary Carlson
    Rep. Gene Davis
    Rep. Margaret Dayton
    Rep. Bryan D. Holladay
    Rep. Robert H.M. Killpack
    Rep. Carl R. Saunders
    Rep. Raymond W. Short



    
Members Absent:

    Sen. Pete Suazo
    Sen. Craig L. Taylor
    Rep. J. W. "Bill" Hickman
    
    
Staff Present:
    Mr. Mark D. Andrews
     Research Analyst
    Ms. Janetha W. Hancock
     Associate General Counsel
    Mr. R. Chet Loftis
     Associate General Counsel
    Ms. Karen E. Mecham
     Secretary


Note:    A list of others present and a copy of materials distributed in the meeting are on file in the Office of Legislative Research and General Counsel.
    

1.    Call to Order and Approval of June 18 Minutes -- Rep. Stephens called the meeting to order at 10:00 a.m. and welcomed members of the committee.

     MOTION: Rep. Carlson moved to approve the minutes of the June 18, 1997 meeting. The motion passed unanimously. Reps. Davis, Holladay, Saunders, and Short were absent for the vote.

2.    Children in the Custody of the Division of Child and Family Services (DCFS), Department of Human Services

    a. Adoption

    i. Privatization of adoption processes for children in DCFS custody. Ms. Hancock distributed a handout outlining the current statutes governing the division with regard to the adoption of children in DCFS custody. She reviewed the statutes giving direction to the search for an adoptive home with the child's best interest as the basis of the decision. After the adoption plan is established, the division is to place the child within 30 days. If a home is not found, the division must contract with private adoption agencies to search for and place the child for adoption. The division is also to ensure that the children continue to receive the benefits they are entitled to under state and federal law.

    Ms. Hancock said the division is required to set standards and curriculum for training private adoption agency employees regarding the special needs of DCFS children. She said that licensed agencies and DCFS must now share information and provide potential adoptive parents with information regarding children in DCFS custody, and the support available for children, as well as training and support for the adoptive parents. Finally, she said that the court must give special consideration to the foster parents relationship with the child if the foster parents apply to adopt a child who has been in their home for 6 months or longer.

    Ms. Robin Arnold-Williams, Executive Director, Department of Human Services (DHS), distributed two handouts outlining how children are placed for adoption through DHS. She provided a definition of "Children with Special Needs."

    Ms. Arnold-Williams also discussed the private/public partnership in adoption and the exchanges which register the children's names for placement. She said that if a child is not placed through these exchanges, their names are placed on a national registry. She said that by December, DHS will have an exchange of its own. She noted that the DCFS Policy Board has recently developed an Adoption Advisory Council to advise the Board on recruitment of adoptive homes and the placement of adoptees. Sen. Peterson asked that children not placed by these methods also be accounted for. Ms. Arnold-Williams said that information would be provided. It was noted that most children who are in the custody of the state have special needs. Rep. Killpack asked for suggestions from the department to assist expediting termination of parental rights hearings. It was noted that legal services for indigent parents, especially in rural counties, are difficult to find. Ms. Arnold-Williams also distributed and discussed a handout concerning outcome performance goals for the protection of the children in state custody.

    Mr. Scott Clark, Chair of the Board of Child and Family Services, discussed concerns with policies proposed by the division in connection with the implementation of H.B. 109, "Adoption of Children in Division of Child and Family Services Custody." He said the thrust of the policy is to "license" parents through the Office of Licensing. He said that he felt this is the wrong way to go because it adds layers of studies and requirements that slow down the approval process for adoptive parents. He added that the policy was rejected by the Board and recommendations were provided to the agency with the goal of reviewing changes again on August 1. He said that the standards for adoption agencies are also being reviewed. He said that the goal for the board is to create a partnership between the agency and private organizations to make the adoption process smoother for adoptive parents and children. He cautioned that not every private agency has the perspective of the state.

    Mr. Clark also expressed concern that use of the division's available data base could be abused. He explained that there are upwards of 1,000 people who have access to the data base. He said an informal inquiry is being conducted by the Utah Advisory Board of the U.S. Civil Rights Commission and they would like to cooperate in finding solutions to that potential abuse. Additionally, he noted that the juvenile judges are telling him that they do not have the resources

to meet the deadlines mandated in the statutes and that is causing the delays experienced in the process.

    Mr. Andrews said that he had attempted to collect data on how other states deal with the adoption of children in state custody but that the data does not seem to be already compiled by any organization. He did, however, have information on several states. He said that Kansas recently implemented a managed care approach contracting with Lutheran Social Services to place children. Kansas pays a flat rate of $13,556 for placement of a child. He said that Kansas also has standards requiring placement of 70 percent of the children within six months of referral, finalizing 90 percent of placements within a year, getting a 90 percent satisfaction rate from the families, placing 65 percent of the sibling groups together with the same family, and having 90 percent of children moving to foster families no more than twice while awaiting adoption. He noted that this standard is much higher than what the state was accomplishing previously. Mr. Andrews said this is the only state that has this system based on a capitated rate. He noted that Alberta, Canada is planning to model Kansas' plan soon. He explained that in some states adoption of children in custody is county oriented while in others it is state oriented and said that Philadelphia has had a managed care plan for five years. Hamilton County, Ohio is beginning a process to involve managed care principles. He added that Michigan and Ohio make payments at different points along the adoption process.
        
    ii. Ongoing counseling services for families who adopt DCFS children. Rep. Stephens introduced the issue of ongoing counseling services for families who adopt DCFS children and said that while H.B. 109 passed, the funding mechanism was removed. She distributed draft legislation that would mandate the division to provide intensive training and ongoing support to potential adoptive parents, as needed until the child reaches age 21 years. She explained that in Utah between 1993 and 1996 there were 623 placed for adoption and of those, 248 had a placement change. She noted that these children often have difficult problems to deal with and families give up on the adoption and return the children to the state. She felt that parents and children need help as they make the adjustments needed to develop a family.

     MOTION: Sen. Tanner moved to adopt the bill as a committee bill.

    Rep. Carlson said that a specific amount of money needs to be written into the bill before it is introduced. Rep. Killpack expressed concern that there is an opportunity for abuse. Sen. Peterson recommended that these concerns be addressed in the legislation.

    Returning to the motion, Chair Stephens called for the vote. The motion passed unanimously. Reps. Davis, Holladay, Saunders, and Short were absent for the vote.

    iii. Tax incentives for adoption. Not discussed.

    b.    Foster care

    i. Statewide implementation of foster care citizen review boards. Chair Stephens distributed a bill titled "Statewide Implementation of Foster Care Citizen Review Boards." Ms. Patricia Worthington, Director of the Foster Care Citizen Review Board (FCCRB), distributed a summary of her comments. She said that the current statute requires that the FCCRB conduct periodic reviews of children in out-of-home care. She noted that there are 22 boards now in operation with more than 200 citizen volunteers serving around the state. She expected that by the end of 1997 there will be 30 boards utilizing almost 300 volunteers. She said that in the rural areas of the state they expect to do reviews every three and nine months and along the Wasatch Front every six months. She supported the bill because it would allow 100 percent of children in out-of-home care in Utah to receive an independent review.

     MOTION: Sen. Peterson moved to adopt the bill as a committee bill. The motion passed unanimously. Reps. Davis, Holladay, and Saunders were absent for the vote.

    ii. Management Letter No. 96-27, Office of the State Auditor. Mr. Joe Christensen, Audit Manager, Office of the State Auditor, distributed copies of the DHS portion of the federal compliance audit and discussed Management Letter No. 96-27, the review results dealing with foster care. He expressed concern that the error rate was too high and the federal government could, based on the DHS error rate, require that the state pay back a significantly higher amount of federal funds than the estimate in the audit which was based on the audit sample only. He noted that the errors are occurring in two areas: 1) payments to ineligible providers/individuals; and 2) lack of documentation that would allow them to be eligible. Mr. Christensen said that one of the problems with the process is that all present forms are not being filled out completely . Ms. Arnold-Williams responded to the audit stating that the department's responses are included in the audit report. She said that constant training continues to help increase compliance.

    c.    H.B. 388 (1997), Governor's Budget Requirements _ Not discussed.

4.    Other Business -- The next meeting of the committee will be held on August 20, 1997 in room 405 at 9:00 a.m. Items on the agenda not discussed at this meeting will be first on the agenda of the next meeting.

5.    Adjournment_

     MOTION: Sen. Tanner moved to adjourn the meeting at 11:50 a.m. Reps. Baca, Davis, Holladay, and Saunders were absent for the vote.

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